This invention relates generally to methods and apparatus for communicating health instructions to users.
Healthcare costs around the world have been rising. One reason is that, obesity is common, serious and costly. A Duke University study suggests that by 2030, about 42% of Americans will be obese, which is up from 36% in 2012 and will cost about $550 billion dollars. Even small reductions in obesity prevalence “could result in substantial savings,” wrote the authors. Obesity-related conditions increase the odds of heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death. In 2008, medical costs associated with obesity were estimated at $147 billion; the medical costs for people who are obese were $1,429 higher than those of normal weight.
Obesity affects some groups more than others. Non-Hispanic blacks have the highest age-adjusted rates of obesity (49.5%) compared with Mexican Americans (40.4%), all Hispanics (39.1%) and non-Hispanic whites (34.3%). Among non-Hispanic black and Mexican-American men, those with higher incomes are more likely to be obese than those with low income. Higher income women are less likely to be obese than low-income women. There is no significant relationship between obesity and education among men. Among women, however, there is a trend—those with college degrees are less likely to be obese compared with less educated women. Thus, education appears to be key. Between 1988-1994 and 2007-2008 the prevalence of obesity increased in adults at all income and education levels.
A government solution has been suggested. For example, a ban on the use of trans fats in NY restaurants has sharply reduced the consumption of these unhealthy fats among fast-food customers. However, the government and regulation may not be the best way to solve the problem.
To treat obesity in a cost effective manner, coordination is needed among different service providers such as dieticians, doctors, and exercise coaches. However, planning information, alerts and reminders may be haphazardly and intermittently distributed to doctors, clinicians, or their staff with existing healthcare appointment and scheduling systems and do not support multi-vendor calendaring system that shares information among the different providers. This occurs in other treatments as well. For example, in the case of a patient scheduled for radiation therapy, an existing system may be aware of a necessary number of appointments and treatment orders, but these numbers typically are not compatible with the (e.g., one or more) treatment plans involved. Consequently, a clinician needs to work out a referral connection manually for each appointment. The existing systems also require manual coordination of appointments with treatment plan goals and treatment plan results which occupies a significant amount of clinician time in gathering, collating and analyzing information.
One way to monitor the impact of obesity is to monitor blood pressure. As discussed in U.S. Pat. No. 6,514,211, three well known techniques have been used to non-invasively monitor a subject's arterial blood pressure waveform: auscultation, oscillometry, and tonometry. The auscultation and oscillometry techniques use a standard inflatable arm cuff that occludes the subject's brachial artery. The auscultatory technique determines the subject's systolic and diastolic pressures by monitoring certain Korotkoff sounds that occur as the cuff is slowly deflated. The oscillometric technique, on the other hand, determines these pressures, as well as the subject's mean pressure, by measuring actual pressure changes that occur in the cuff as the cuff is deflated. Both techniques determine pressure values only intermittently, because of the need to alternately inflate and deflate the cuff, and they cannot replicate the subject's actual blood pressure waveform. Occlusive cuff instruments of the kind described briefly above generally have been effective in sensing long-term trends in a subject's blood pressure, but they have been ineffective in sensing short-term blood pressure variations.
The '211 patent discloses blood pressure measurement by determining the mean arterial blood pressure (MAP) of a subject during tonometric conditions. The apparatus has one or more pressure and ultrasound transducers placed over the radial artery of a human subject's wrist, the latter transmitting and receiving acoustic energy so as to permit the measurement of blood velocity during periods of variable compression of the artery. During compression, the ultrasound velocity waveforms are recorded and processed using time-frequency analysis. The time at which the mean time-frequency distribution is maximal corresponds to the time at which the transmural pressure equals zero, and the mean pressure read by the transducer equals the mean pressure within the artery. In another aspect of the invention, the ultrasound transducer is used to position the transducer over the artery such that the accuracy of the measurement is maximized.